• 【环境内分泌干扰物双酚A和血脂异常之间的关系:五年的前瞻性研究。】 复制标题 收藏 收藏
    DOI:10.4158/EP-2019-0384 复制DOI
    作者列表:Li R,Yang S,Gao R,Deng Y,Liu J,Yuan C,Yao Q,Lv X,Wang K,Ye X,Peng B,Hu J,Chen A
    BACKGROUND & AIMS: : Objective: To investigate whether serum bisphenol A (BPA) concentration is related to the occurrence of dyslipidemia. Methods: A total of 574 adults were enrolled at baseline and followed up for 5 years. Concentrations of serum BPA, triglycerides (TGs), low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol were measured. Dyslipidemia was defined as the existence of one or more of the following conditions: high-LDL-cholesterolemia (LDL ≥140 mg/dL), hypertriglyceridemia (TGs ≥150 mg/dL), or low-HDL-cholesterolemia (HDL <40 mg/dL). Participants were stratified into tertiles according to low, median, and high baseline serum BPA levels. Multivariable linear and logistic regression models were used. Data from baseline and follow-up were used for cross-sectional and longitudinal analyses, respectively. Results: In the cross-sectional analysis, compared to subjects in the low BPA tertile, those in the high BPA tertile showed a higher level of LDL cholesterol (108.1 ± 24.4 mg/dL versus 119.5 ± 26.9 mg/dL; P<.05) and a lower level of HDL cholesterol (46.2 ± 11.7 mg/dL versus 39.5 ± 7.5 mg/dL; P<.05). In multivariable linear regression models, Z-transformed BPA was positively associated with LDL cholesterol (β= 0.13, P = .002) and negatively associated with HDL cholesterol (β= -0.28; P<.001). After cross-sectionally adjusting for confounders, subjects in higher BPA exposure was associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, in subjects without low-HDL-cholesterolemia at baseline, each SD increment in baseline BPA was associated with a higher incidence of low-HDL-cholesterolemia after adjustment for confounders (odds ratio [95% confidence interval; CI] 2.76, 95% CI 1.21, 6.29). Conclusion: Cross-sectionally, higher BPA exposure is associated with a higher prevalence of low-HDL-cholesterolemia. Longitudinally, baseline BPA is an independent predictor of the 5-year incidence of low-HDL-cholesterolemia. Abbreviations: BMI = body mass index; BPA = bisphenol A; CI = confidence interval; CVD = cardiovascular disease; EIMDS = environment, inflammation and metabolic diseases study; HDL = high density lipoprotein; LDL = low density lipoprotein; OR = odds ratio; PPAR = peroxisome proliferator-activated receptor; SBP = systolic blood pressure; TG = triglyceride; Z-BPA = Z-transformed bisphenol A.
    背景与目标:
    客观的:
    调查血清双酚A(BPA)浓度是否与血脂异常的发生有关。
    方法:
    基线时共有574名成年人入组,并随访5年。测量血清BPA,甘油三酸酯(TGs),低密度脂蛋白(LDL)胆固醇和高密度脂蛋白(HDL)胆固醇的浓度。血脂异常被定义为存在以下一种或多种状况:高LDL胆固醇血症(LDL≥140mg / dL),高甘油三酯血症(TGs≥150mg / dL)或低HDL胆固醇血症(HDL <40 mg / dL)。根据低,中和高基线血清BPA水平将参与者分为三部分。使用多变量线性和逻辑回归模型。来自基线和随访的数据分别用于横截面和纵向分析。
    结果:
    在横断面分析中,与低BPA三分位数的受试者相比,高BPA三分位数的受试者显示更高的LDL胆固醇水平(108.1±24.4 mg / dL与119.5±26.9 mg / dL; P <.05)和降低了HDL胆固醇水平(46.2±11.7 mg / dL与39.5±7.5 mg / dL; P <.05)。在多变量线性回归模型中,Z转化的BPA与LDL胆固醇呈正相关(β= 0.13,P = .002),与HDL胆固醇呈负相关(β= -0.28; P <.001)。在针对混杂因素进行横断面调整后,BPA暴露量较高的受试者与低HDL胆固醇血症的患病率较高相关。纵向上,在基线时没有低HDL胆固醇血症的受试者中,校正混杂因素后,基线BPA的每个SD升高与低HDL胆固醇血症的发生率较高相关(比值比[95%置信区间; CI] 2.76、95% CI 1.21,6.29)。
    结论:
    从横截面来看,较高的BPA暴露与低HDL胆固醇血症的较高患病率相关。纵向上,基线BPA是低HDL胆固醇血症5年发生率的独立预测因子。缩写:BMI =体重指数; BPA =双酚A; CI =置信区间; CVD =心血管疾病; EIMDS =环境,炎症和代谢性疾病研究; HDL =高密度脂蛋白; LDL =低密度脂蛋白; OR =比值比; PPAR =过氧化物酶体增殖物激活受体; SBP =收缩压; TG =甘油三酸酯; Z-BPA = Z转化的双酚A。
  • 【全面的代谢评估显示,在疾病轨迹的早期,乳腺癌患者的葡萄糖代谢和血脂异常受损。】 复制标题 收藏 收藏
    DOI:10.1016/j.clnu.2013.08.001 复制DOI
    作者列表:Bell KE,Di Sebastiano KM,Vance V,Hanning R,Mitchell A,Quadrilatero J,Russell C,Dubin JA,Bahl M,Califaretti N,Campbell C,Mourtzakis M
    BACKGROUND & AIMS: BACKGROUND & AIMS:Weight gain in breast cancer patients during treatment is prevalent; the metabolic implications of this weight gain are poorly understood. We aimed to characterize glucose metabolism in breast cancer patients near the initiation of chemotherapy. METHODS:Stage I-II breast cancer patients (n = 8) were evaluated near the initiation of chemotherapy and compared with a group of age- and body mass index-matched, as well as a group of young healthy, non-malignant females. Fasting blood samples (analyzed for lipids and cytokines) were taken and an oral glucose tolerance test was performed. Body composition, waist circumference, diet, cardiovascular fitness and muscle strength were evaluated. RESULTS:Breast cancer patients were abdominally obese (mean ± SD: 94.6 ± 14.0 cm), overweight (28.8 ± 6.0 kg/m(2)) and dyslipidemic (triacylglycerides: 1.84 ± 1.17 mM; high-density lipoprotein cholesterol: 1.08 ± 0.23 mM). Compared to non-malignant matched females, fasting glucose and insulin concentrations were similar but fasting c-peptide was greater in patients (2.6 ± 1.2 ng/mL vs. 1.9 ± 0.8 ng/mL, p = 0.005). Glucose was elevated to a greater extent in patients during the oral glucose tolerance test compared with all non-malignant females. During the glucose tolerance test, c-peptide, but not insulin, remained elevated in patients compared with all non-malignant females. No differences in body composition, serum cytokines, nutrition or exercise capacity between patients and matched, non-malignant females emerged. CONCLUSIONS:Breast cancer patients present with unhealthy metabolic features early in the disease trajectory. Future investigations need to examine the underlying mechanisms and the potential longitudinal changes following chemotherapy.
    背景与目标: 背景与目的:乳腺癌患者在治疗过程中体重增加十分普遍。人们对这种体重增加的代谢影响知之甚少。我们旨在表征乳腺癌患者在开始化疗之前的葡萄糖代谢。
    方法:在开始化疗之前对I-II期乳腺癌患者(n = 8)进行了评估,并与年龄和体重指数匹配的一组患者以及一组年轻健康的非恶性女性进行了比较。抽取空腹血液样品(分析脂质和细胞因子),并进行口服葡萄糖耐量试验。评估了身体成分,腰围,饮食,心血管健康状况和肌肉力量。
    结果:乳腺癌患者的腹部肥胖(平均±SD:94.6±14.0 cm),超重(28.8±6.0 kg / m(2))和血脂异常(甘油三酸酯:1.84±1.17 mM;高密度脂蛋白胆固醇:1.08±0.23)毫米)。与非恶性配对女性相比,患者的空腹葡萄糖和胰岛素浓度相似,但患者的空腹c肽含量更高(2.6±1.2 ng / mL与1.9±0.8 ng / mL,p = 0.005)。与所有非恶性女性相比,口服葡萄糖耐量测试期间患者的葡萄糖升高幅度更大。在葡萄糖耐量测试中,与所有非恶性女性相比,患者的c肽而非胰岛素仍然升高。患者与配对的,非恶性的女性之间在身体组成,血清细胞因子,营养或运动能力方面无差异。
    结论:乳腺癌患者在疾病发展的早期就表现出不健康的代谢特征。未来的研究需要检查化学疗法后的潜在机制和潜在的纵向变化。
  • 【1型糖尿病儿童和青少年的血脂异常及其相关因素的患病率。】 复制标题 收藏 收藏
    DOI:10.1515/jpem-2016-0111 复制DOI
    作者列表:Bulut T,Demirel F,Metin A
    BACKGROUND & AIMS: BACKGROUND:Dyslipidemia increases the frequency and severity of micro and macrovascular complications of type 1 diabetes (T1D). The present study aims to determine the prevalence of dyslipidemia and its association with clinical and laboratory findings in diabetic children and adolescents. METHODS:The study included 202 children and adolescents with T1D. Demographic data and laboratory findings were obtained from patients files. RESULTS:Dyslipidemia prevalence was found to be 26.2%. Hypercholesterolemia (15.8%) and hyperglyceridemia (12.9%) were most common findings. Age, body mass index (BMI), hemoglobin A1c (A1C) and poor metabolic control were significantly higher in cases with dyslipidemia. Smoking rate was 14.1% in the pubertal group. Poor metabolic control and dyslipidemia was found higher among smokers (p<0.05). CONCLUSIONS:Blood lipid levels should be monitored regularly and nutrition education should be repeated periodically to prevent and control dyslipidemia in patients with T1D. Smoking-related risks should be a part of patient education in the pubertal period.
    背景与目标: 背景:血脂异常会增加1型糖尿病(T1D)的微血管和大血管并发症的发生频率和严重程度。本研究旨在确定血脂异常的患病率及其与糖尿病儿童和青少年的临床和实验室检查结果的关系。
    方法:该研究包括202名患有T1D的儿童和青少年。人口统计学数据和实验室检查结果来自患者档案。
    结果:血脂异常患病率为26.2%。高胆固醇血症(15.8%)和高甘油血症(12.9%)是最常见的发现。血脂异常患者的年龄,体重指数(BMI),血红蛋白A1c(A1C)和不良的代谢控制均明显更高。青春期组吸烟率为14.1%。在吸烟者中,不良的代谢控制和血脂异常被发现较高(p <0.05)。
    结论:应定期监测血脂水平,并定期重复营养教育,以预防和控制T1D患者的血脂异常。在青春期,与吸烟有关的风险应作为患者教育的一部分。
  • 【阿托伐他汀对绝经后血脂异常妇女骨骼的影响:一项双盲,安慰剂对照,剂量范围试验。】 复制标题 收藏 收藏
    DOI:10.1210/jc.2006-1909 复制DOI
    作者列表:Bone HG,Kiel DP,Lindsay RS,Lewiecki EM,Bolognese MA,Leary ET,Lowe W,McClung MR
    BACKGROUND & AIMS: CONTEXT:In preclinical models, inhibitors of 3-hydroxy-3-methylglutaryl-coenzyme A reductase have been shown to positively affect bone remodeling balance. Observational studies and secondary analyses from lipid-lowering trials have yielded inconsistent results regarding the effect of these agents on bone mineral density and fracture risk. OBJECTIVE:Our objective was to determine whether clinically significant skeletal benefits result from hydroxymethylglutaryl-coenzyme A reductase inhibition in postmenopausal women. DESIGN AND SETTING:We conducted a prospective, randomized, double-blind, placebo-controlled, dose-ranging comparative clinical trial at 62 sites in the United States. PARTICIPANTS:Participants included 626 postmenopausal women with low-density lipoprotein cholesterol levels of at least 130 mg/dl (3.4 mmol/liter) and less than 190 mg/dl (4.9 mmol/liter), and lumbar (L1-L4) spine bone mineral density T-score between 0.0 and -2.5. INTERVENTION:Once-daily placebo or 10, 20, 40, or 80 mg atorvastatin was administered. MAIN OUTCOME MEASURES:We assessed percent change from baseline in lumbar (L1-L4) spine bone mineral density with each dose of atorvastatin compared with placebo. RESULTS:At 52 wk, there was no significant difference between each atorvastatin and placebo group or change from baseline at any tested dose of atorvastatin or placebo in lumbar (L1-L4) spine bone mineral density. Nor did atorvastatin produce a significant change in bone mineral density at any other site. Changes in biochemical markers of bone turnover did not differ significantly between each atorvastatin and placebo group. All doses of atorvastatin were generally well tolerated, with similar incidences of adverse events across all dose groups and placebo. CONCLUSIONS:Clinically relevant doses of atorvastatin that lower lipid levels had no effect on bone mineral density or biochemical indices of bone metabolism in this study, suggesting that such oral agents are not useful in the prevention or treatment of osteoporosis.
    背景与目标: 背景:在临床前模型中,已证明3-羟基-3-甲基戊二酰辅酶A还原酶的抑制剂可积极影响骨骼重塑平衡。降脂试验的观察性研究和二级分析得出了关于这些药物对骨矿物质密度和骨折风险的影响的不一致结果。
    目的:我们的目的是确定对绝经后妇女的羟甲基戊二酰辅酶A还原酶抑制作用是否产生临床上显着的骨骼益处。
    设计与地点:我们在美国的62个地点进行了一项前瞻性,随机,双盲,安慰剂对照,剂量范围比较的临床试验。
    参与者:626名绝经后妇女的低密度脂蛋白胆固醇水平至少为130 mg / dl(3.4 mmol /升)且低于190 mg / dl(4.9 mmol /升),并且腰部(L1-L4)脊柱骨矿物密度T分数在0.0到-2.5之间。
    干预:每天一次安慰剂或10、20、40或80毫克阿托伐他汀。
    主要观察指标:我们评估了每种剂量的阿托伐他汀与安慰剂相比腰椎(L1-L4)脊柱骨矿物质密度相对于基线的变化百分比。
    结果:在第52周时,每个阿托伐他汀和安慰剂组之间的腰椎(L1-L4)脊柱骨矿物质密度均无显着差异,或在任何测试剂量的阿托伐他汀或安慰剂下与基线相比无显着差异。阿托伐他汀在任何其他部位均未产生明显的骨矿物质密度变化。每个阿托伐他汀组与安慰剂组之间骨转换的生化标志物变化均无显着差异。通常所有剂量的阿托伐他汀都具有良好的耐受性,所有剂量组和安慰剂的不良事件发生率均相似。
    结论:本研究中临床相关剂量的阿托伐他汀对降低血脂水平没有影响,但对骨矿物质密度或骨代谢的生化指标没有影响,这表明此类口服药物对预防或治疗骨质疏松症无用。
  • 【随机对照试验的设计和原理,测试单独应用STAtin联合FENO贝特和他汀类药物在非糖尿病合并血脂异常合并非介入性中间冠状动脉疾病的患者中的疗效-STAFE】 复制标题 收藏 收藏
    DOI:10.1186/s13063-020-04291-5 复制DOI
    作者列表:Kwon TG,Jang AY,Kim SW,Hong YJ,Bae JH,Lee SY,Kim SH,Han SH
    BACKGROUND & AIMS: BACKGROUND:Despite the chronicled success of low-density lipoprotein cholesterol (LDLc)-lowering statin therapy, substantial residual cardiovascular (CV) disease risk remains a problem worldwide, highlighting the need to for combination therapies targeting non-LDLc factors, such as with fenofibrate. METHODS/DESIGN:The STAFENO trial is a prospective, randomized, open-label, multi-center trial to compare the effect of statin plus fenofibrate with statin alone on the reduction and stabilization of plaque in non-diabetic, combined dyslipidemia patients with non-intervened, intermediate coronary artery disease (CAD) using virtual histology-intravascular ultrasound at 12 months. A total of 106 eligible patients are planned to be randomized to receive either a combination therapy (rosuvastatin 10 mg plus fenofibrate 160 mg/day) or monotherapy (rosuvastatin 10 mg/day) for 12 months. The primary endpoint of this study is the percentage change in the necrotic core volume. Secondary endpoints include changes in tissue characteristics and 1-year major CV events, including all-cause mortality, CV mortality, nonfatal myocardial infarction, stroke, and revascularization of the intervened and non-intervened lesions. DISCUSSION:The STAFENO trial will address whether combination treatment of statin and fenofibrate has an additive beneficial effect compared to statin alone on the reduction and stabilization of plaque and CV events in non-diabetic, combined dyslipidemia patients with non-intervened intermediate CAD. TRIAL REGISTRATION:ClinicalTrials.gov, NCT02232360. Registered 9 February 2014. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0004ULE&selectaction=Edit&uid=U00023SZ&ts=2&cx=juppd2.
    背景与目标: 背景:尽管低密度脂蛋白胆固醇(LDLc)降低他汀类药物疗法取得了长期成功,但全球范围内仍然存在大量残留心血管(CV)疾病的风险,这凸显出需要针对非LDLc因子(如非诺贝特)的联合疗法。
    方法/设计:STAFENO试验是一项前瞻性,随机,开放标签,多中心试验,用于比较他汀类药物与非诺贝特联合他汀类药物对非糖尿病合并血脂异常非糖尿病患者减少和稳定斑块的作用。在12个月时使用虚拟组织学-血管内超声干预介入的中级冠状动脉疾病(CAD)。计划将总共106名符合条件的患者随机分组接受联合治疗(罗舒伐他汀10μmg/每天加非诺贝特160μmg/天)或单药治疗(罗舒伐他汀10μmg/天),持续12个月。这项研究的主要终点是坏死核心体积的百分比变化。次要终点包括组织特征的变化和1年主要CV事件,包括全因死亡率,CV死亡率,非致命性心肌梗塞,中风以及介入和非介入病变的血运重建。
    讨论:STAFENO试验将探讨与单独使用他汀类药物相比,他汀类药物与非诺贝特的联合治疗是否对非糖尿病,合并性血脂异常患者和非介入性中度CAD患者的斑块和CV事件的减少和稳定有额外的有益作用。
    试用注册:ClinicalTrials.gov,NCT02232360。 2014年2月9日注册。https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0004ULE&selectaction=Edit&uid=U00023SZ&ts=2&cx=juppd2。
  • 【中孕早期的血脂异常主要是子痫前期发作的女性的特征。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2001-10-01
    来源期刊:BJOG
    DOI:10.1111/j.1471-0528.2001.00247.x 复制DOI
    作者列表:Clausen T,Djurovic S,Henriksen T
    BACKGROUND & AIMS: OBJECTIVE:To investigate whether hypertriglyceridemic dyslipidemia is a risk factor for either early or late onset pre-eclampsia. DESIGN:Prospective cohort study and nested case-control study. SETTING:Aker Hospital: a university hospital with all levels of obstetric care. PARTICIPANTS:2,157 Caucasian pregnant women. METHODS:Blood samples were obtained from non-fasting subjects at 18 weeks of gestation. All samples were analysed for triglycerides, total-cholesterol, high density lipoproteins cholesterol and non-high density lipoproteins cholesterol. ApoB-100 were analysed in pre-eclamptic women and in 3:1 matched controls. The cohort data were analysed by multiple logistic regression and the case-control data by conditional logistic regression. MAIN OUTCOME MEASURES:Adjusted odds ratios of early and late onset pre-eclampsia according to early second trimester serum concentration levels of lipids and ApoB-100. RESULTS:Eighteen women developed early onset pre-eclampsia and 53 women developed late onset pre-eclampsia. In the cohort model, women with triglycerides above 2.4mmol/L had increased risk (OR 5. 1; 95% CI 1.1-23.1) of early onset pre-eclampsia compared with those with triglycerides levels < or = 1.5mmol/L. For women with high triglycerides: non-high density lipoproteins cholesterol ratios (>90 centile) the OR (95% CI) for early onset pre-eclampsia was 7.1 (2.3-22.0) compared with those with low ratios (< or = 50 centile). Similar associations were found in the case control model. We found no associations between plasma lipids and risk of late onset pre-eclampsia. CONCLUSIONS:Hypertriglyceridemic dyslipidemia before 20 weeks of gestation is associated with the risk of developing early but not late onset pre-eclampsia, giving support to the contention that these two variants of the disease are at least partly pathogenically different.
    背景与目标: 目的:探讨高甘油三脂血症性血脂异常是否是子痫前期或晚期先兆子痫的危险因素。
    设计:前瞻性队列研究和嵌套病例对照研究。
    地点:阿克医院:一家拥有各级产科护理服务的大学医院。
    参加人数:2,157名白人孕妇。
    方法:在妊娠18周时从非禁食的受试者中获取血液样本。分析所有样品的甘油三酸酯,总胆固醇,高密度脂蛋白胆固醇和非高密度脂蛋白胆固醇。在先兆子痫妇女和3:1匹配对照中分析了ApoB-100。队列数据通过多元逻辑回归分析,病例对照数据通过条件逻辑回归分析。
    主要观察指标:根据妊娠中期早期血脂和ApoB-100的水平,调整先兆子痫和晚期子痫前期的比值比。
    结果:18例妇女先兆子痫发作,53例妇女先兆子痫发作。在队列模型中,与甘油三酯水平<或= 1.5mmol / L的妇女相比,甘油三酯高于2.4mmol / L的妇女发生子痫前期的风险增加(OR 5. 1; 95%CI 1.1-23.1)。对于甘油三酸酯含量高的妇女:非高密度脂蛋白胆固醇比率(> 90个百分位),与先兆子痫前期先兆子痫的OR(95%CI)相比,低比率(<或= 50个百分位) )。在病例对照模型中发现了相似的关联。我们发现血浆脂质与先兆子痫晚期发作的风险之间没有关联。
    结论:妊娠20周前的高甘油三酯血症性血脂异常与发生先兆子痫而不是晚发作先兆子痫的风险有关,这支持了该疾病的这两种变异至少在部分病因上不同的观点。
  • 【哈萨克斯坦阿斯塔纳地区城市和农村人口中老年人血脂异常的发生率,认识,治疗和控制。】 复制标题 收藏 收藏
    DOI:10.1186/s12889-017-4629-5 复制DOI
    作者列表:Supiyev A,Nurgozhin T,Zhumadilov Z,Peasey A,Hubacek JA,Bobak M
    BACKGROUND & AIMS: BACKGROUND:Despite high cardiovascular mortality in Central Asian republics of the former Soviet Union, there is limited information about major risk factors, including blood lipids. We investigated the prevalence of impaired concentrations of blood lipids, the awareness, treatment and control of hypercholesterolemia, and factors associated with these indicators in urban and rural populations in Kazakhstan. METHODS:We conducted a cross-sectional study of random urban and rural population samples (the state capital Astana and Akmol village). Men and women aged 50-74 years were examined; a total of 954 adults participated (response rate 59%). Serum concentrations of total, LDL and HDL cholesterol and triglycerides and a range of other cardiovascular risk factors were measured. RESULTS:The overall prevalence of hypercholesterolemia (total cholesterol ≥6.2 mmol/l) was 37%; among subjects with hypercholesterolemia, 57% were aware of their condition, 41% took medication and 23% had total cholesterol <6.2 mmol/l (4.5% <5 mmol/l). The prevalence, awareness, treatment, and control of hypercholesterolemia were all higher in the urban than the rural area. Similarly, the proportions of subjects with impaired concentrations of specific lipids fractions were also considerably higher in the urban population. Most associations with other covariates were in the expected direction. CONCLUSIONS:This study found relatively high prevalence of dyslipidemia in the Kazakh population, and the blood lipid profile was less favourable in the urban area. These pronounced urban-rural differences may be related to urbanization, the associated nutrition transition and to access to health care.
    背景与目标: 背景:尽管前苏联中亚共和国的心血管死亡率很高,但有关主要危险因素(包括血脂)的信息有限。我们调查了哈萨克斯坦城市和农村人口中血脂水平降低的患病率,高胆固醇血症的认识,治疗和控制以及与这些指标相关的因素。
    方法:我们对城市和农村的随机样本(州首府阿斯塔纳和阿克莫尔村)进行了横断面研究。检查了50-74岁的男性和女性;共有954位成人参加(响应率59%)。测量了血清总胆固醇,低密度脂蛋白和高密度脂蛋白胆固醇和甘油三酸酯的浓度,以及一系列其他心血管危险因素。
    结果:高胆固醇血症的总患病率(总胆固醇≥6.2mmol / l)为37%;在高胆固醇血症患者中,有57%知道自己的病情,有41%服用过药物,有23%的总胆固醇<6.2 mmol / l(4.5%<5 mmol / l)。高胆固醇血症的患病率,意识,治疗和控制在城市中均高于农村地区。同样,在城市人群中,特定脂质组分的浓度受损的受试者所占的比例也相当高。与其他协变量的大多数关联都处于预期的方向。
    结论:本研究发现哈萨克族人群血脂异常患病率较高,城市地区的血脂状况较差。这些明显的城乡差异可能与城市化,相关的营养过渡以及获得医疗服务有关。
  • 【鱼油补充剂治疗血脂异常。】 复制标题 收藏 收藏
    DOI:10.1097/HNP.0b013e3181e901fb 复制DOI
    作者列表:Hessel JA
    BACKGROUND & AIMS: :The use of herbal and natural remedies to prevent and manage disease is increasing in popularity. Individuals are attracted to the nonsynthetic qualities, affordability, and purity of natural remedies as compared to standard pharmacological and invasive interventions. Fish oil supplementation, for example, has been used in the management of dyslipidemia in patients choosing a natural approach to treatment or in adjunct to prescribed medication regimens. Research studies have supported the use of fish oil supplementation to reduce elevated levels of triglycerides and increase healthy cholesterol levels, as well as reduce the risk factors for cardiovascular disease. In this article, the use of fish oil supplementation to manage dyslipidemia will be explored, and considerations for this therapy for health care providers will be discussed.
    背景与目标: :越来越多的人使用草药和天然疗法预防和控制疾病。与标准的药理和侵入性干预措施相比,个人对自然疗法的非合成质量,可负担性和纯度很感兴趣。例如,鱼油补充剂已用于治疗血脂异常的患者,这些患者选择了自然疗法或与处方药物疗法相辅相成。研究支持使用鱼油补充剂来降低甘油三酸酯水平升高和健康胆固醇水平升高,以及降低心血管疾病的危险因素。在本文中,将探讨使用鱼油补充剂治疗血脂异常的情况,并讨论对医疗保健提供者使用该疗法的注意事项。
  • 【高危动脉粥样硬化和代谢表型:异位肥胖,致动脉粥样硬化血脂异常和炎症的作用。】 复制标题 收藏 收藏
    DOI:10.1089/met.2019.0115 复制DOI
    作者列表:Lechner K,McKenzie AL,Kränkel N,Von Schacky C,Worm N,Nixdorff U,Lechner B,Scherr J,Weingärtner O,Krauss RM
    BACKGROUND & AIMS: :Current algorithms for assessing risk of atherosclerotic cardiovascular disease (ASCVD) and, in particular, the reliance on low-density lipoprotein (LDL) cholesterol in conditions where this measurement is discordant with apoB and LDL-particle concentrations fail to identify a sizeable part of the population at high risk for adverse cardiovascular events. This results in missed opportunities for ASCVD prevention, most notably in those with metabolic syndrome, prediabetes, and diabetes. There is substantial evidence that accumulation of ectopic fat and associated metabolic traits are markers for and pathogenic components of high-risk atherosclerosis. Conceptually, the subset of advanced lesions in high-risk atherosclerosis that triggers vascular complications is closely related to a set of coordinated high-risk traits clustering around a distinct metabolic phenotype. A key feature of this phenotype is accumulation of ectopic fat, which, coupled with age-related muscle loss, creates a milieu conducive for the development of ASCVD: atherogenic dyslipidemia, nonresolving inflammation, endothelial dysfunction, hyperinsulinemia, and impaired fibrinolysis. Sustained vascular inflammation, a hallmark of high-risk atherosclerosis, impairs plaque stabilization in this phenotype. This review describes how metabolic and inflammatory processes that are promoted in large measure by ectopic adiposity, as opposed to subcutaneous adipose tissue, relate to the pathogenesis of high-risk atherosclerosis. Clinical biomarkers indicative of these processes provide incremental information to standard risk factor algorithms and advanced lipid testing identifies atherogenic lipoprotein patterns that are below the discrimination level of standard lipid testing. This has the potential to enable improved identification of high-risk patients who are candidates for therapeutic interventions aimed at prevention of ASCVD.
    背景与目标: :目前评估动脉粥样硬化性心血管疾病(ASCVD)风险的算法,尤其是在这种测量与apoB和LDL颗粒浓度不一致的情况下,对低密度脂蛋白(LDL)胆固醇的依赖发生心血管不良事件的高风险人群。这导致错过了进行ASCVD预防的机会,最明显的是那些患有代谢综合征,糖尿病前期和糖尿病的患者。有大量证据表明,异位脂肪的积累和相关的代谢特征是高危动脉粥样硬化的标志物和致病成分。从概念上讲,触发血管并发症的高危动脉粥样硬化晚期病变的子集与一组围绕独特的代谢表型聚集的协调一致的高危性状密切相关。该表型的关键特征是异位脂肪的积累,再加上与年龄相关的肌肉流失,形成了有利于ASCVD发展的环境:动脉粥样硬化血脂异常,无法解决的炎症,内皮功能障碍,高胰岛素血症和纤维蛋白溶解受损。持续的血管炎症是高危动脉粥样硬化的标志,损害了该表型的斑块稳定。这篇综述描述了与皮下脂肪组织相反,异位肥胖在很大程度上促进了代谢和炎症过程与高危动脉粥样硬化的发病机理的关系。指示这些过程的临床生物标记物为标准危险因素算法提供了增量信息,而先进的脂质测试可识别出低于标准脂质测试的鉴别水平的致动脉粥样硬化脂蛋白模式。这有可能改善对高风险患者的识别,这些高风险患者是旨在预防ASCVD的治疗干预措施的候选人。
  • 【槲皮素可能会减轻镉诱导的大鼠氧化应激介导的心脏毒性和血脂异常。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Milton Prabu S,Muthumani M,Shagirtha K
    BACKGROUND & AIMS: BACKGROUND:Cadmium is one of the potent cardiotoxic heavy metals in the environment, which induces oxidative stress, dyslipidemia and membrane disturbances in heart. Quercetin is an effective antioxidant and free radical scavenger against oxidative stress. This study was designed to evaluate the protective effect of quercetin (QE) on cardiac marker enzymes, lipid peroxidation products, lipid profile, membrane bound ATPases and antioxidant status in cadmium (Cd)-intoxicated rats. MATERIALS AND METHODS:Twenty four male albino rats were used. Cadmium induced oxidative cardiotoxicity was induced by the oral administration of Cd for four weeks. Quercetin  was pretreated along with Cd for four weeks to assess its cardioprotective effect against Cd intoxication. Rats treated with vehicles alone were used as controls. RESULTS:Rats intoxicated with cadmium (5 mg/kg/day) for 4 weeks in combination with quercetin (50 mg/kg/day) respectively. Cd-induced cardiotoxicity and dyslipidemia was indicated by increased activities of marker enzymes such as creatine kinase-MB, aspartate transaminase, alanine transaminase, alkaline phosphatase and lactate dehydrogenase in serum. In addition, the levels of lipid peroxidation products and protein carbonyl contents in heart were significantly (p < 0.05) increased and the activities of enzymic antioxidants such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase in the heart and non-enzymic antioxidants such as glutathione, vitamin C and E in the heart were significantly (p < 0.05) decreased in Cd intoxicated rats. The levels total cholesterol (TC), triglycerides (TG), phospholipidis (PL), free fatty acids (FFA), LDL and VLDL were significantly (p < 0.05) increased and the level of HDL was significantly decreased in the serum of Cd-treated rats. Cd intoxication also increased the levels of TC, TG and FFA and decreased the level of PL in the heart tissue. Further Cd treatment significantly (p < 0.05) decreased the levels of membrane bound ATP ases in heart. QE treatment along with Cd showed significant protective effect on all the biochemical parameters studied. Histopathological findings of QE and Cd treated heart confirmed the biochemical findings of this study. Thus, QE protects the myocardium against Cd-induced oxidative stress and dyslipidemia in rats. CONCLUSIONS:Quercetin may be beneficial in combating the cadmium induced oxidative cardiotoxicity and dyslipidemia in rats.  
    背景与目标: 背景:镉是环境中有效的心脏毒性重金属之一,可引起心脏氧化应激,血脂异常和膜紊乱。槲皮素是一种有效的抗氧化剂和自由基清除剂,可抵抗氧化应激。这项研究旨在评估槲皮素(QE)对镉(Cd)中毒大鼠心脏标志物酶,脂质过氧化产物,脂质分布,膜结合ATP酶和抗氧化剂状态的保护作用。
    材料与方法:使用24只雄性白化病大鼠。口服镉持续四周可诱发镉引起的氧化性心脏毒性。槲皮素与Cd一起进行了为期四周的预处理,以评估其对Cd中毒的心脏保护作用。仅用媒介物治疗的大鼠用作对照。
    结果:分别用镉(5 mg / kg /天)和槲皮素(50 mg / kg /天)中毒的大鼠连续4周。血清中肌酸激酶-MB,天冬氨酸转氨酶,丙氨酸转氨酶,碱性磷酸酶和乳酸脱氢酶等标记酶活性的增加表明了镉诱导的心脏毒性和血脂异常。此外,心脏中脂质过氧化产物和蛋白质羰基含量的水平显着增加(p <0.05),并且酶抗氧化剂的活性,例如超氧化物歧化酶,过氧化氢酶,谷胱甘肽过氧化物酶,谷胱甘肽还原酶和谷胱甘肽S-转移酶镉中毒大鼠心脏中的非酶类抗氧化剂如谷胱甘肽,维生素C和E显着降低(p <0.05)。 Cd-血清中的总胆固醇(TC),甘油三酸酯(TG),磷脂(PL),游离脂肪酸(FFA),LDL和VLDL的水平显着升高(p <0.05),HDL的水平显着降低治疗的大鼠。镉中毒还会增加心脏组织中TC,TG和FFA的水平,并降低PL的水平。进一步的Cd处理显着(p <0.05)降低了心脏中与膜结合的ATP酶的水平。 QE处理和Cd处理对所研究的所有生化参数均显示出显着的保护作用。 QE和Cd治疗的心脏的组织病理学发现证实了这项研究的生化发现。因此,QE保护心肌免受Cd诱导的大鼠氧化应激和血脂异常的影响。
    结论:槲皮素可能有助于对抗镉诱导的大鼠氧化性心脏毒性和血脂异常。
  • 【低脂联素血症,血脂异常,以及与HIV相关的面部脂肪萎缩症患儿的生长受损。】 复制标题 收藏 收藏
    DOI:10.1515/jpem.2007.20.1.65 复制DOI
    作者列表:Kim RJ,Carlow DC,Rutstein JH,Rutstein RM
    BACKGROUND & AIMS: OBJECTIVE:To compare growth, lipids and adipocytokines in HIV-positive children with and without lipoatrophy. PATIENTS:Eleven HIV-positive children with facial lipoatrophy, and 22 age- and sex-matched HIV-positive controls without signs of fat abnormality. METHODS:Clinical data including height, physical examination findings, medications, markers of viral control, cholesterol, and triglycerides were retrieved from the medical charts. Serum samples were analyzed for adiponectin, inflammatory markers, and high density lipoprotein cholesterol (HDL). RESULTS:Lipoatrophy was associated with higher triglycerides (330 vs 133 mg/dl, p = 0.0003), lower HDL (33 vs 48 mg/dl, p = 0.02), and a greater frequency of hypercholesterolemia (total cholesterol > 200 mg/dl; 64% vs 23%, p < 0.03). Adiponectin was 53% lower in patients with lipodystrophy (6.9 microg/ml vs 14.8 microg/ml, p = 0.005), however there was no difference in the inflammatory markers soluble TNFa receptor 2 or interleukin 6. Strikingly, despite similar BMI z-scores and virological control, lipoatrophic patients were shorter by 1 standard deviation score (p = 0.03). CONCLUSIONS:The presence of facial lipoatrophy in a child with HIV infection is a marker for significant metabolic derangements including dyslipidemia and hypoadiponectinemia, and suggests the need for careful growth evaluation.
    背景与目标: 目的:比较有和没有脂肪萎缩的HIV阳性儿童的生长,脂质和脂肪细胞因子。
    患者:11名患有面部脂肪萎缩的HIV阳性儿童,以及22名年龄和性别相匹配的HIV阳性对照,无脂肪异常迹象。
    方法:从医学图表中检索临床数据,包括身高,体格检查结果,药物,病毒控制指标,胆固醇和甘油三酸酯。分析血清样品中的脂联素,炎性标志物和高密度脂蛋白胆固醇(HDL)。
    结果:脂肪萎缩与甘油三酸酯含量较高(330 vs 133 mg / dl,p = 0.0003),HDL较低(33 vs 48 mg / dl,p = 0.02)和高胆固醇血症发生频率较高(总胆固醇> 200 mg / dl)有关; 64%和23%,p <0.03)。脂肪营养不良患者的脂联素降低了53%(6.9微克/毫升对14.8微克/毫升,p = 0.005),但是炎症标志物可溶性TNFa受体2或白介素6没有差异。令人惊讶的是,尽管BMI z评分相似与病毒学对照相比,脂肪萎缩患者的病程缩短了1个标准差评分(p = 0.03)。
    结论:HIV感染患儿面部脂肪萎缩是代谢异常的标志,包括血脂异常和低脂联素血症,提示需要进行仔细的生长评估。
  • 【在中国儿童血脂异常筛查中,针对性别和年龄的临界点相对于NCEP儿科临界点的表现。】 复制标题 收藏 收藏
    DOI:10.1016/j.atherosclerosis.2018.11.018 复制DOI
    作者列表:Xiao P,Huang T,Yan Y,Zhao X,Li H,Mi J,China Child and Adolescent Cardiovascular Health (CCACH) investigators.
    BACKGROUND & AIMS: BACKGROUND AND AIMS:Considerable attention is given nowadays to the presence of cardiovascular diseases risk factors in children. The current blood lipid classification system for Chinese children was based on the United States National Cholesterol Education Program (NCEP) cutpoints, which did not take the age, gender and race differences into consideration. This study aimed to develop gender- and age-specific lipid cutpoints for dyslipidemia screening in Chinese children and compare the ability of new cutpoints and NCEP pediatric cutpoints to predict obesity and unfavorable blood pressure (BP) levels. METHODS:Data were obtained from a nationwide multicenter cross-sectional study: The China Child and Adolescent Cardiovascular Health Study, comprising 12,875 Chinese children aged 6-18 years. We calculated cutpoints for abnormal levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) that were linked to Chinese adult abnormal lipid thresholds using the General Additive Model for Location Scale and Shape method. RESULTS:Borderline-high and high cutpoints (TC, LDL-C and TG) as well as low cutpoints (HDL-C) were developed to classify the abnormal blood lipid levels in Chinese children. Better performance for prediction of obesity, elevated BP, and hypertension were found with the proposed cutpoints in comparison with the NCEP pediatric cutpoints (AUC for obesity: 0.612 vs. 0.597, p = 0.017; AUC for elevated BP: 0.529 vs. 0.521, p = 0.017; AUC for hypertension: 0.536 vs. 0.527, p = 0.016). CONCLUSIONS:The gender- and age-specific cutpoints should improve the accuracy of dyslipidemia screening in China and be more reasonable in practice.
    背景与目标: 背景与目的:当今人们对儿童心血管疾病危险因素的存在给予了极大的关注。当前针对中国儿童的血脂分类系统基于美国国家胆固醇教育计划(NCEP)的临界点,未考虑年龄,性别和种族差异。这项研究旨在开发针对中国儿童血脂异常筛查的按性别和年龄划分的脂质临界点,并比较新临界点和NCEP儿科临界点预测肥胖和不利血压(BP)水平的能力。
    方法:数据来自一项全国性的多中心横断面研究:“中国儿童和青少年心血管健康研究”,包括12875名6-18岁的中国儿童。我们使用与中国成人异常脂质阈值相关的总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C)和甘油三酸酯(TG)异常水平的切入点进行了计算位置比例尺和形状方法的通用加性模型。
    结果:开发了高,高临界值(TC,LDL-C和TG)以及低临界值(HDL-C)以对中国儿童的异常血脂水平进行分类。与NCEP儿科临界点相比,建议的临界点发现了更好的预测肥胖,血压升高和高血压的性能(肥胖的AUC:0.612比0.597,p = 0.017;血压升高的AUC:0.529比0.521,p = 0.017;高血压的AUC:0.536 vs. 0.527,p = 0.016)。
    结论:按性别和年龄分界点可提高中国血脂异常筛查的准确性,在实践中应更合理。
  • 【烟酸缓释单药治疗慢性四肢瘫痪患者血脂异常风险的安全性,耐受性和有效性:一项随机的多中心对照试验。】 复制标题 收藏 收藏
    DOI:10.1016/j.apmr.2010.06.029 复制DOI
    作者列表:Nash MS,Lewis JE,Dyson-Hudson TA,Szlachcic Y,Yee F,Mendez AJ,Spungen AM,Bauman WA
    BACKGROUND & AIMS: OBJECTIVE:To test the safety, tolerance, and efficacy of extended-release niacin monotherapy on dyslipidemia in persons with chronic tetraplegia. DESIGN:Placebo-controlled, blinded, multicenter, randomized controlled trial. SETTING:Three spinal cord injury research/rehabilitation centers. PARTICIPANTS:Persons with chronic tetraplegia (N=54) and low plasma high-density lipoprotein cholesterol (HDL-C) levels. INTERVENTION:Extended-release niacin monotherapy (48 weeks; n=31) on a dose-titration schedule versus matched placebo (n=23). MAIN OUTCOME MEASURES:Safety was assessed by using percentages of treatment-emergent adverse events and increased levels of hepatic transaminases, uric acid, glycosylated hemoglobin, and fasting glucose. Tolerance was assessed by using participant reports for frequency and intensity of adverse effects of extended-release niacin. Primary effectiveness outcomes were fasting HDL-C level and plasma total cholesterol (TC)/HDL-C ratio. Secondary outcomes included plasma low-density lipoprotein cholesterol (LDL-C) and TC levels and LDL-C/HDL-C ratio. RESULTS:Significant increases in fasting HDL-C levels (24.5%) were accompanied by decreases in TC/HDL-C and LDL-C/HDL-C ratios, LDL-C levels, and TC levels (all P<.05). No evidence of sustained hepatotoxicity or hyperglycemia was observed. Treatment-emergent withdrawals (12.9%) accompanied flushing (n=1), hypotension/presyncope (n=1), and diarrhea (n=2). One subject experienced transient hyperuricemia. Other drug-reported symptoms did not differ from those for placebo. CONCLUSIONS:Extended-release niacin monotherapy is safe, tolerated, and effective for most persons with chronic tetraplegia. Special precautions for changes in bowel habits and postadministration hypotension should be observed.
    背景与目标: 目的:探讨烟酸缓释单药治疗慢性四肢瘫痪患者血脂异常的安全性,耐受性和疗效。
    设计:安慰剂对照,双盲,多中心,随机对照试验。
    地点:三个脊髓损伤研究/康复中心。
    参与者:慢性四肢瘫痪(N = 54)和血浆高密度脂蛋白胆固醇(HDL-C)水平低的人。
    干预:按剂量滴定方案延长烟酸单药治疗(48周; n = 31),而与之匹配的安慰剂(n = 23)。
    主要观察指标:使用治疗紧急不良事件的百分比以及肝转氨酶,尿酸,糖基化血红蛋白和空腹血糖水平的增加来评估安全性。通过使用参与者报告评估缓释烟酸不良反应的发生频率和强度,以评估耐受性。主要疗效结果是禁食HDL-C水平和血浆总胆固醇(TC)/ HDL-C比值。次要结果包括血浆低密度脂蛋白胆固醇(LDL-C)和TC水平以及LDL-C / HDL-C比。
    结果:空腹HDL-C水平显着增加(24.5%),同时TC / HDL-C和LDL-C / HDL-C比率,LDL-C水平和TC水平降低(均P <.05)。没有观察到持续的肝毒性或高血糖的证据。紧急治疗时停药(12.9%)伴有潮红(n = 1),低血压/晕厥(n = 1)和腹泻(n = 2)。一名受试者经历了短暂性高尿酸血症。其他药物报告的症状与安慰剂无差异。
    结论:烟酸缓释单药对大多数慢性四肢瘫痪患者是安全,可耐受且有效的。应注意改变大便习惯和给药后低血压的特殊预防措施。
  • 【血管生成素样蛋白3在恒河猴猕猴糖诱导的血脂异常中的作用:鱼油或RNAi的抑制作用。】 复制标题 收藏 收藏
    DOI:10.1194/jlr.RA119000423 复制DOI
    作者列表:Butler AA,Graham JL,Stanhope KL,Wong S,King S,Bremer AA,Krauss RM,Hamilton J,Havel PJ
    BACKGROUND & AIMS: :Angiopoietin-like protein 3 (ANGPTL3) inhibits lipid clearance and is a promising target for managing cardiovascular disease. Here we investigated the effects of a high-sugar (high-fructose) diet on circulating ANGPTL3 concentrations in rhesus macaques. Plasma ANGPTL3 concentrations increased ∼30% to 40% after 1 and 3 months of a high-fructose diet (both P < 0.001 vs. baseline). During fructose-induced metabolic dysregulation, plasma ANGPTL3 concentrations were positively correlated with circulating indices of insulin resistance [assessed with fasting insulin and the homeostatic model assessment of insulin resistance (HOMA-IR)], hypertriglyceridemia, adiposity (assessed as leptin), and systemic inflammation [C-reactive peptide (CRP)] and negatively correlated with plasma levels of the insulin-sensitizing hormone adropin. Multiple regression analyses identified a strong association between circulating APOC3 and ANGPTL3 concentrations. Higher baseline plasma levels of both ANGPTL3 and APOC3 were associated with an increased risk for fructose-induced insulin resistance. Fish oil previously shown to prevent insulin resistance and hypertriglyceridemia in this model prevented increases of ANGPTL3 without affecting systemic inflammation (increased plasma CRP and interleukin-6 concentrations). ANGPTL3 RNAi lowered plasma concentrations of ANGPTL3, triglycerides (TGs), VLDL-C, APOC3, and APOE. These decreases were consistent with a reduced risk of atherosclerosis. In summary, dietary sugar-induced increases of circulating ANGPTL3 concentrations after metabolic dysregulation correlated positively with leptin levels, HOMA-IR, and dyslipidemia. Targeting ANGPTL3 expression with RNAi inhibited dyslipidemia by lowering plasma TGs, VLDL-C, APOC3, and APOE levels in rhesus macaques.
    背景与目标: :血管生成素样蛋白3(ANGPTL3)抑制脂质清除,是治疗心血管疾病的有希望的靶标。在这里,我们研究了高糖(高果糖)饮食对恒河猴猕猴中循环ANGPTL3浓度的影响。高果糖饮食1个月和3个月后,血浆ANGPTL3浓度增加了约30%至40%(P <0.001与基线相比)。在果糖引起的代谢失调期间,血浆ANGPTL3浓度与胰岛素抵抗的循环指标[空腹胰岛素和胰岛素抵抗的稳态模型评估(HOMA-IR)],高甘油三酯血症,肥胖(评估为瘦素)和全身性呈正相关。炎症[C反应肽(CRP)],与胰岛素敏感性激素adropin的血浆水平呈负相关。多元回归分析确定循环的APOC3和ANGPTL3浓度之间有很强的联系。 ANGPTL3和APOC3的基线血浆水平较高与果糖诱导的胰岛素抵抗风险增加有关。在该模型中先前显示出可预防胰岛素抵抗和高甘油三酯血症的鱼油可防止ANGPTL3升高,而不会影响全身性炎症(血浆CRP和白介素6浓度升高)。 ANGPTL3 RNAi降低了ANGPTL3,甘油三酸酯(TGs),VLDL-C,APOC3和APOE的血浆浓度。这些减少与动脉粥样硬化风险的降低相一致。总之,代谢失调后饮食中糖引起的循环性ANGPTL3浓度增加与瘦素水平,HOMA-IR和血脂异常呈正相关。用RNAi靶向ANGPTL3表达可通过降低猕猴的血浆TG,VLDL-C,APOC3和APOE水平来抑制血脂异常。
  • 【患有外周动脉疾病的患者血脂异常的诊断和治疗被忽略。】 复制标题 收藏 收藏
    DOI:10.1080/14017430601187751 复制DOI
    作者列表:Poussa H,Strandberg TE,Tikkanen I,Kauhanen P,Lepäntalo M
    BACKGROUND & AIMS: OBJECTIVE:Our aim was to investigate how dyslipidemia was diagnosed and treated in patients with peripheral artery disease (PAD) in a university vascular clinic. DESIGN:Our analysis included all 1 843 PAD patients (median age 71 years, interquartile range 63-79, M/W 975/868) who attended the clinic in 2002-2003 either for diagnostic angiography or for revascularization. The charts of patients tested for dyslipidemia were reviewed closer. RESULTS:Serum lipids were measured in only 214 PAD patients (11.6%). Of them 37.9% smoked, 59.8% had antihypertensive medication, 35.0% diabetes, and 30.8% a history of coronary heart disease. Mean serum cholesterol concentration was 4.5 mmol/l (SD 1.3), LDL-cholesterol 2.54 (0.48), HDL-cholesterol 1.25 (0.48), and triglycerides 1.62 (0.84). Only 40 patients (19.7%) were using statins, this was increased to 72 (33.6%) after clinic visit. Consequently, 50.0% and 53.2% met the current total cholesterol (<4.5 mmol/l) and LDL-cholesterol (<2.5 mmol/l) goals, respectively. CONCLUSIONS:Dyslipidemia was highly under-diagnosed among PAD patients. Serum lipids were measured only in a minority and among them serum lipid values and the use of hypolipidemic drugs were not optimal according to guidelines.
    背景与目标: 目的:我们的目的是研究在大学血管诊所对患有外周动脉疾病(PAD)的患者进行血脂异常的诊断和治疗的方法。
    设计:我们的分析包括2002年至2003年就诊于诊断性血管造影或血管重建术的所有1843名PAD患者(中位年龄71岁,四分位间距63-79,M / W 975/868)。血脂异常检查患者的病历表进行了仔细回顾。
    结果:仅214名PAD患者中测量了血清脂质(11.6%)。其中37.9%的吸烟者,59.8%的患者服用降压药,35.0%的糖尿病患者和30.8%的冠心病史。平均血清胆固醇浓度为4.5 mmol / l(SD 1.3),LDL-胆固醇2.54(0.48),HDL-胆固醇1.25(0.48)和甘油三酸酯1.62(0.84)。只有40例患者(19.7%)使用他汀类药物,到诊所就诊后增加到72例(33.6%)。因此,分别达到当前总胆固醇(<4.5 mmol / l)和LDL-胆固醇(<2.5 mmol / l)的目标的分别为50.0%和53.2%。
    结论:PAD患者的血脂异常被高度诊断不足。仅在少数人群中测量了血脂,其中血脂值和降血脂药物的使用不是根据指南的最佳方法。

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